Dilatrend Roche treat hypertension, coronary artery disease, chronic heart failure, left ventricular failure (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Carvedilol

Ingredient

Composition information	Content
Carvedilol	25mg

Uses

indications

The drug is indicated in the following cases:

Hypertension

dilatrend is indicated in the treatment of primary hypertension. The drug can be used alone or in combination with other antihypertensive drugs (for example, calcium channel blockers, diuretics).

coronary artery disease

Carvedilol is clinically effective in the treatment of coronary artery disease. Preliminary data has shown that the drug is effective and safe when used for patients with unstable angina and myocardial ischemia without symptoms.

Chronic heart failure

Unless there is contraindicated, Carvedilol is indicated in combination with standard treatments (including transferred and diuretical inhibitors, with or without Digitalis) to treat all patients with stable chronic heart failure, symptoms from mild, medium to severe, due to or non -medium anemia.

Left ventricular failure after acute myocardial infarction

After having myocardial infarction, there is a left ventricular failure (LVEF) of left ventricle (LVEF) smaller than or equal to 40% or the index of solicitation is smaller than or equal to 1.3), a long -term treatment for patients after cardiomyopathy with Carvedilol in combination with transferred inhibitors and other therapies.

Pharmacokology

Carvedilol is a multi-effect Adrenergic receptor inhibitor with adrenergic alpha-1, beta-1 and beta-2 receptor properties.

Carvedilol reduces tachycardia through beta adrenergic antagonism and reduces blood pressure through adrenergic alpha-1 antagonism. The drug has a long time because it is often used once a day and has a wide treatment index because patients often use 10-80mg per day. Patients who are taking Carvedilol should not suddenly stop taking this medication as this may worsen coronary artery disease.

Pharmacokinetics

absorption

Carvedilol is quickly absorbed after drinking. In healthy people, the maximum concentration in the serum reaches about 1 hour after use. The absolute bioavailability of Carvedilol in humans is about 25%.

Distribution

Carvedilol is very fat. Linking with plasma proteins is about 98 to 99%. The integral distribution is approximately 2 l/kg and increases in cirrhosis patients.

Metabolism

Carvedilol is metabolized mainly in the liver, through the glucuronid -conjugated reaction.

Elimination

The average selling time of Carvedilol is about 6 hours. The clearance in plasma is about 500-700 ml / min. Elimination mainly through bile and excreted mainly through feces. A small part is eliminated through the kidneys in the form of different metabolites.

Before taking Dilatrend Roche treat hypertension, coronary artery disease, chronic heart failure, left ventricular failure (3 blisters x 10 tablets)

How to use

oral medication.

Dosage

Treatment time

Carvedilol treatment is a long -term treatment. Like all beta blockers, it is not advisable to stop treating suddenly but should reduce the dose slowly weekly. This is especially important in the case of patients with coronary artery disease.

Hypertension

The starting dose is recommended for 12.5mg, once a day for the first two days. After that, the recommended dose is 25mg, once a day. If necessary, at least two weeks later, it may increase the dose to the maximum daily dose recommended by 50mg, once used or twice daily.

coronary artery disease

The starting dose is recommended by 12.5mg, twice daily, in the first two days. Then the recommended dose is 25mg, twice daily. If necessary, at least two weeks later, it can increase the dose to the maximum daily dose recommended by 100mg, divided into twice daily

Chronic heart failure

The doctor must do the appropriate dose for each patient and carefully monitor the dose during the dose measurement.

For patients being treated with digitalis, diuretics and enzyme inhibitors, the dose of these drugs should be stable before starting the kite with Carvedilol.

The starting dose is recommended by 3,125mg, twice a day, for two weeks. If this dose is tolerated, at least two weeks later, it may increase the dose to 6.25mg, 12.5mg and 25mg, use twice daily. The dose may increase to the highest level that the patient can tolerate. The maximum dose is recommended for 25mg, twice daily for all patients with severe heart failure and for patients with chronic heart failure from mild to medium weight weighing less than 85kg. For patients with mild or moderate heart failure, weighing over 85kg, the maximum dose is recommended to be 50mg, twice daily.

Before each dose increases, the doctor needs to evaluate symptoms of vasodilation or more severe heart failure in the patient. The severe heart failure or water retention can be treated by increasing diuretics. Sometimes it is necessary to reduce the dose of carvedilol, and in very rare cases, it is necessary to temporarily use carvedilol.

The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when using overdose?

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using the drug, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Hematology: Anemia

Circulation system: heart failure, tachycardia, increased circulatory volume, circulatory overload. vision: Reduce vision, dry eyes, eye irritation.

Digestive system: Nausea, diarrhea, vomiting, indigestion, abdominal pain.

Respiratory system: pneumonia

Uncommon, 1/1000

The circulatory system: atrial block, angina.

Digestive system: Constipation

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Hypersensitivity to Carvedilol or with any excipients of Carvedilol; sieve;

bronchial asthma; mmHg);

Prinzmetal angina;

Be cautious when using

Use Carvedilol cautiously in patients with congestion heart failure treatment with digitalis, diuretics, or enzyme inhibitors that transferred angiotensin due to atrial - ventricular can be slowed.

Be careful in patients with diabetes with no or difficult to control, because beta receptor blockers can cover symptoms of blood glucose.

Must stop treatment when there is signs of liver damage.

Must be cautious in people with peripheral blood vessels, people with anesthesia, people with increased thyroid function.

If the patient does not tolerate other anti -hypertension drugs, caution can be used with very small doses of carvedilol for people with bronchospasm.

Avoid stopping the drug suddenly, to stop the drug for 1-2 weeks.

Consider the risk of arrhythmia, if using carvedilol simultaneously with anesthetic smell. The risk must be considered if combined with carvedilol with anti -arrhythmia group I.

The ability to drive and operate machinery

There are no studies on the effects of the drug on and operating machinery. Due to the reaction of each person (for example, dizziness), the ability to drive, operate machines or work without support may be impaired. This usually happens when it is started to treat, after increasing the dose, changing drugs, or taking the drug with alcohol.

Pregnancy

Carvedilol has caused clinical damage in pregnancy. Only use this medication during pregnancy if the expected benefit is greater than the risk that may occur and as usual, not used in the last three months of pregnancy or almost birth.

Unwanted effects for fetuses such as slow heartbeat, lowering blood pressure, respiratory inhibition, reducing glucose - blood and reducing body temperature in infants can be used by pregnancy.

breastfeeding period

carvedilol can excrete in breast milk. There is no risk of unwanted effect in breastfeeding.

Drug interaction

reduced effects:

Rifampicin can reduce plasma concentrations of carvedilol to 70%.

The effect of other beta blockers decreases when combined with aluminum salts, barbiturates, calcium salts, cholestyramin, colestipol, non -selective blockers A1, penicillin (ampicillin), salicylate, and sulfinyrazon due to biodiversity reduction and plasma concentration.

Increase effect:

Carvedilol can increase the effects of anti -diabetes drugs, channel blockers - calcium, digoxin.

Carvedilol's interaction with clonidin can lead to an increase in blood pressure and reduce heart rate.

cimetidine increases the effects and bioavailability of carvedilol.

Other drugs that are capable of increasing the concentration and effects of carvedilol include quinidin, fluoxetin, paroxetin, and propafenon because these drugs inhibit CYP2D6.

Carvedilol increases the concentration of digoxin about 20% when taken at the same time.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

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